The diagnosis of anthracycline-induced cardiac damage and heart failure

Routine examinations during chemotherapy containing anthracyclines evaluate heart function before treatment and monitor cardiotoxic effects during and after therapy. A number of methods are useful in cardiac assessment, including electrocardiography, radiology techniques (RTG, CT, MRI,PET-CT, PET-MRI), echocardiography, radioisotope imaging techniques (scintigraphy, MUGA,PET), and ultra-structure evaluation in biopsy samples. Nevertheless, there is a continuous need for new methods to predict future damage at the initial stages of cardiac changes. In recent years the therapeutic usefulness of biochemical blood parameters in anthracycline-treated patients has been assessed. The levels of cardiac troponins (cTnI, cTnT), natriuretic peptides (ANP, BNP), and endothelin 1 have been included in the studies. Heart-type fatty acid binding protein (H-FABP) is another promising factor showing cardiomyocytic impairment. However, the clinical use of biochemical parameters in diagnosing anthracycline-related cardiotoxicity is still a controversial issue.